STUDY OBJECTIVE: We assess the feasibility, effectiveness, and cost of routinely recommended HIV/sexually transmitted disease screening in an urban emergency department (ED). METHODS: From April 2003 to August 2004, patients aged 15 to 54 years were offered rapid HIV testing, and those aged 15 to 25 years were also offered gonorrhea and chlamydia testing (nucleic acid amplification), Monday through Friday, 11 am to 8 pm. Infected patients were referred for treatment and care. Prevalence, treatment rates, and cost were assessed. RESULTS: Among 3,030 patients offered HIV testing, 1,447 (47.8%) accepted, 8 (0.6%) tested positive, and 3 (37.5%) were linked to care. Among 791 patients offered sexually transmitted disease testing, 386 (48.8%) accepted, 320 provided urine (82.9%), 48 (15.0%) tested positive, and 42 (87.5%) were treated for gonorrhea or chlamydia. The program cost was $72,928. Costs per HIV-infected patient identified and linked to care were, respectively, $9,116 and $24,309; cost per sexually transmitted disease-infected patient treated was $1,736. The program cost for HIV/sexually transmitted disease screening was only $14,340 more than if we screened only for HIV. CONCLUSION: Through ED-based HIV/sexually transmitted disease screening, we identified and treated many sexually transmitted disease-infected patients but identified few HIV-infected patients and linked even fewer to care. However, sexually transmitted disease screening can be added to HIV screening at a reasonable cost.
STUDY OBJECTIVE: We assess the feasibility, effectiveness, and cost of routinely recommended HIV/sexually transmitted disease screening in an urban emergency department (ED). METHODS: From April 2003 to August 2004, patients aged 15 to 54 years were offered rapid HIV testing, and those aged 15 to 25 years were also offered gonorrhea and chlamydia testing (nucleic acid amplification), Monday through Friday, 11 am to 8 pm. Infected patients were referred for treatment and care. Prevalence, treatment rates, and cost were assessed. RESULTS: Among 3,030 patients offered HIV testing, 1,447 (47.8%) accepted, 8 (0.6%) tested positive, and 3 (37.5%) were linked to care. Among 791 patients offered sexually transmitted disease testing, 386 (48.8%) accepted, 320 provided urine (82.9%), 48 (15.0%) tested positive, and 42 (87.5%) were treated for gonorrhea or chlamydia. The program cost was $72,928. Costs per HIV-infectedpatient identified and linked to care were, respectively, $9,116 and $24,309; cost per sexually transmitted disease-infectedpatient treated was $1,736. The program cost for HIV/sexually transmitted disease screening was only $14,340 more than if we screened only for HIV. CONCLUSION: Through ED-based HIV/sexually transmitted disease screening, we identified and treated many sexually transmitted disease-infectedpatients but identified few HIV-infectedpatients and linked even fewer to care. However, sexually transmitted disease screening can be added to HIV screening at a reasonable cost.
Authors: Roland C Merchant; Bethany M Catanzaro; George R Seage; Kenneth H Mayer; Melissa A Clark; Victor G Degruttola; Bruce M Becker Journal: J Med Screen Date: 2009 Impact factor: 2.136
Authors: Roland C Merchant; George R Seage; Kenneth H Mayer; Melissa A Clark; Victor G DeGruttola; Bruce M Becker Journal: Public Health Rep Date: 2008 Nov-Dec Impact factor: 2.792
Authors: Michael S Lyons; Christopher J Lindsell; Jason S Haukoos; Gregory Almond; Jeremy Brown; Yvette Calderon; Eileen Couture; Roland C Merchant; Douglas A E White; Richard E Rothman; Chris Aldridge; Gregory Almond; Gregory Andrade; Christian Arbelaez; Tom-meka Archinard; Steven I Aronin; Susan Barrera; Moses Bateganya; Joanna Bell-Merriam; Bob Bongiovanni; Kathleen Brady; Bernard Branson; Carol Brosgart; Jeremy Brown; Evan Cadoff; Yvette Calderon; Linda Chaille-Arnold; Ben Cheng; William Chiang; Brittney Copeland; Rosalyn L Cousar; Eileen Couture; Maggie Czarnogorski; Kit Delgado; Emily Erbelding; James Feldman; Osvaldo Garcia; Charlotte A Gaydos; Nancy Glick; Barbara Gripshover; Jason Haukoos; Alisa Hayes; James Heffelfinger; Laura Herrera; Amy Hilley; David Holtgrave; Brooke Hoots; Emily Hopkins; Debra Houry; Debra Howell; Yu-Hsiang Hsieh; Angela B Hutchinson; Blanca Jackson; Michael Jaker; Kerin Jones; Juliana Jung; Linda Kampe; Virginia Kan; Nancy Kass; Gabor D Kelen; Karen Kroc; Ann Kurth; Margaret A Lampe; Jason Leider; Michael Lemanski; Christopher J Lindsell; Michael Lyons; Sandra McGovern; Seth Mercer; Roland Merchant; Nancy Miertschin; Joan Miller; Patricia Mitchell; Sarah Nelson; Linda Onaga; David Paltiel; Sindy Paul; Harold Pollack; Stephen Raffanti; Liisa Randall; Richard Rothman; Akhter Sabreen; Jeffrey Sankoff; Vanessa Sasso; Nathaniel Bernard Saylor; Elissa Schechter; Barbara Schechtman; Steven Schrantz; Alicia Scribner; Judy Shahan; Daniel Skiest; Freya Spielberg; Irijah S Stennett; Patrick Sullivan; Cathalene Teahan; Susan Thompson; Gretchen Torres; Vicken Totten; Krystn Wagner; Rochelle Walensky; Michael Waxman; Andrea Weddle; Douglas White; Tom Widell; James A Wilde; Keith Wrenn; Juliet Yonek Journal: Acad Emerg Med Date: 2008-12-06 Impact factor: 3.451
Authors: Sara C Keller; Baligh R Yehia; Michael G Eberhart; Kathleen A Brady Journal: J Acquir Immune Defic Syndr Date: 2013-08-15 Impact factor: 3.731
Authors: Rochelle P Walensky; Christian Arbelaez; William M Reichmann; Ron M Walls; Jeffrey N Katz; Brian L Block; Matthew Dooley; Adam Hetland; Simeon Kimmel; Jessica D Solomon; Elena Losina Journal: Ann Intern Med Date: 2008-08-05 Impact factor: 25.391
Authors: Christian Arbelaez; Brian Block; Elena Losina; Elizabeth A Wright; William M Reichmann; Regina Mikulinsky; Jessica D Solomon; Matthew M Dooley; Rochelle P Walensky Journal: Int J Emerg Med Date: 2009-09-01